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Step 4: Clinical validation study
Study design
Standard IMRT plan
1. Spare parotid glands
2. NO dose constraints for SWOARs
3. Estimate NTCP for grade II-IV
Dysphagia = NTCPstandard IMRT
4. Save and store (BACK UP plan)
SW-IMRT plan
1. Similar dose to parotid glands
2. Spare SWOARs
3. Estimate NTCP for grade II-IV
Dysphagia = NTCPSW-IMRT
4. Calculate expected ΔNTCP =
NTCPstandard IMRT – NTCPSW-IMRT
Treat
with
SW-IMRT
Courtesy of Hans Langendijk, UMC Groningen